January 17, 2021

Nursing home hidden camera investigation: Understaffed and overworked

Announcer: -[ David ] This isyour Marketplace.

Families on a mission.

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This needs to change, it is totally unacceptable.

-[ David ] .

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to uncoverthe truth.

Nobody was there to help her.

-[ David ] And, we gethired to see what it's really like inside.

Are staff set up to fail? I would not want to be theone in the bed in the state that long-term care is in right now.

Minister Elliottt, I'm David with CBC.

How do you addressthe concerns that these front-lineworkers have? We take theirconcerns very seriously.

-[ David ] A specialedition of your Marketplace.

How to fight for better care.

[ ♪♪ ] [ Moaning ] -[ David ] Listen carefully.

[ Moaning ] -[ David ] The call for helpis faint, but desperate.

[ Moaning ] -[ David ] In the darknessat this long-term care home an 84-year-old grandmotherstruggles to breathe.

[ Faint Moaning ] -[ David ] At home, her daughterMarie had been told staff were checking her momthroughout the night.

[ Faint Moaning ] -[ David ] The breathing getsweaker, and then stops.

She's gone.

Nobody there to help her.

She died alone, struggling.

Nobody was there.

And you're left wonderingif they could have saved her.

I think they could have.

[ Crying Out ] -[ David ] For yearswe've heard your concerns.

What happens to our parentsand grandparents when we are not there? Are there enoughstaff to keep them safe? To find out, we are goingdeep inside long-term care.

-[ David ] Sending a Marketplaceproducer to volunteer, spending more than 60 hoursundercover at Markhaven.

The same home whereMarie's mother died.

Okay.

-[ David ] We are taking careto respect residents' privacy, focusing on common areas.

It does not take longto see staff who try– [ Polka Music Playing ] -[ David ] –but are simplyoutnumbered.

-[ David ] Elderly residentswaiting for help to use the toilet.

-[ David ] Staff just trying tokeep up, racing from person to person.

-[ David ] This is one home, but we are hearing similar stories nationwide.

Our undercover producer is– yousee her roaming the hallways, trying to find someonewho is just available to help with this.

-That is normal, absolutely.

-[ David ] Miranda Ferrierrepresents more than 30, 000 personal support workers, or PSWs in Ontario.

How do you use the wordnormal to describe someone waiting for more than an hour togo to the washroom and there not being someone to help them? It's been acceptedas the norm.

Should it be? Absolutely not, it shouldnot be accepted as the norm.

-[ David ] Unansweredcall bells.

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[ Rhythmic Beeping ] -[ David ] Barely timefor the basics.

-[ David ] By one estimate, Ontario staff only get six minutes to get eachincreasingly frail resident out of bed, dressed, and down for breakfast.

I'm going to wheel you up, Gary.

-[ David ] Staff whowant to do better, but there just is not time.

A lot of the timesin long-term care, nine times out of ten, you are skipping steps.

Whereas– that might be, that day you don't wash under their armpits and you don'twash their nether regions, or, you know, you don'tchange their incontinence product real quick becauseit's not that wet yet, because you don't have the time.

-So you just let them sit in it?-So let– You let them sitin it until it's full.

Because you don'thave the time.

-[ David ] It's not justa problem at one home.

A year ago at another Ontariohome we caught this conversation on hidden camera.

-[ David ] These PSWsare talking to a government inspector.

She is powerless because thereis no minimum staffing ratio for nursing homes.

-[ David ] And whenthere aren't enough staff, the worst becomes possible.

You are a daughter and you arelistening to what sounds like her final breaths.

-Breaths, yep.

Not easy to take.

-Sorry.

-No, no.

I wasn't there to help her.

Nobody was there to help her.

I think that's thebiggest part of it.

-[ David ] Giovanna's deathhappened right after the home's funding was cut by theprovince, forcing it to lay off a night nurse.

Marie's mother died alone, in a home where staff seemed always stretchedand at night, numbers dropped.

Sometimes, just one PSWfor a wing of 27 residents.

She loved to bewith her grandkids.

She laughed a lot.

She told a lot of funny stories.

Fake stories to my kids.

She'd get them going.

She was really funny, shehad a good sense of humour.

A really good sense of humour.

-[ David ] Worried for monthsabout her mother's care, Marie decides to install ahidden camera in her room.

I wasn't going to beable to see her a lot.

In the month of May, I had eye surgery.

-[ David ] Giovanna neededa tracheostomy to breathe, a tube bringingair to her throat.

In case of a problem, thehome's own care plan demanded a call bell within reach.

Whenever she wasn't well shealways held onto that call bell to get help.

-[ David ] On the nightshe died, though, Marie wonders, were staff too busy to check? Too overloaded to noticethe gasp for help? Mom was gone.

And I believe, in all hearts, that the cause of her death was due to lackof experience.

Staffing not knowingwhat they are doing.

Training.

Not enough staff.

What do you wantthe ministry to change? There should be legislationthat has to have more people to take care of our lovedones, more nursing staff, more PSWs on the floor.

-[ David ] We showed thevideo to Miranda and together we notice something alarming.

She was seemingly partially outof the bed trying to reach here.

Oh, my God, where the call bell was.

They left the callbell on the chair.

They left the callbell on the chair.

Ah, sorry.

-[ David ] That call bell, theone required to be in the bed with Giovanna.

Even as she struggled, she couldn't reach it.

No one should haveto suffer like that.

And I mean, the problem isthat they are all suffering like this.

-[ David ] Suffering that Mariedid not know about until months later when shewatched the video.

Staff were supposed to check onGiovanna throughout the night but no one did until morning.

If she was able to get help, the morning that she passed, she would haveprobably been alive.

-[ David ] Workers discoverher body half out of bed.

Marie believes she wastrying to reach that call bell, the one thatmight have saved her.

This is them moving her body.

If her feet were down dangling, she was trying to get help.

She was trying to get up.

And get to her bell.

-To get help.

-To get help.

-[ David ] For two yearswe have been investigating long-term care homes in Ontario.

Now, we are deep undercoverin one home, spending days inside, hearing the consequencesof short staffing.

-[ David ] We have heard thesame story from across Canada, including here inHare Bay, Newfoundland.

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where Sharon Goulding-Collinshas a plan to fight for elderly residents like her mother, who has dementia and lives in a nursing home45 minutes away.

Hi, Mom.

Hi, Mom.

What are you doing? Mom, Mom.

Are you going to have a nap? Are you going to have a nap? -Hi, Sharon.

-Hi.

[ Mother Chattering ] -[ David ] Sharon is now astranger to the woman who spends her days callingfor her own parents.

Yeah.

[ ♪♪ ] It is amazing, she is just so strong.

And then for this to happen? -[ David ] There have neverbeen more dementia residents, like Lillian, in long-term care.

A growing number with veryhigh needs and unpredictability.

Sometimes other dementiapatients become aggressive, and there have been altercationsthat have left Lillian bruised, no staff there to help.

There are so many otherthings that have happened that nobody's seen.

Like the bruises on herfrom here to here.

Like the scratches andcuts on her face.

Like being punchedin the mouth.

But there was nobodythere when it happened? There was nobody there.

-Nobody there to stop it.

-Nobody.

-[ David ] Sharon is usually athome when she hears about a new injury.

An attack from afellow dementia resident.

This can't go on.

This is an 82-year-oldwoman who is getting beaten up.

Um.

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And the response was–and it was not the first time, “I'm sorry but we can't beeverywhere all the time.

” Why do you think that is? Why can't they be therewhen their residents are being attacked by others? Because there'snot enough staff.

There's only somuch that they can do.

-[ David ] Even though theregional health authority says they are fully staffed, theyacknowledge dementia patients can be combative.

So there aresafety plans in place.

300 kilometres away inSt.

John's, Heather Reardon faces that on every shift.

-Hi, Heather?-Hi.

Yeah, I'm David.

On the night shift when staffnumbers drop she's the only registered nurse incharge of 140 patients.

I wish I could split myselfin half because I could be needed upstairs becausesomeone has had a fall, or I could have somebody inrespiratory distress down on another unit, andboth are unstable, and both need aregistered nurse, but there's only one of me.

The quality ofcare is not there.

Simple day-to-daythings are not getting done.

They might only have time– theymay have to leave them in bed.

They may be left in bed the fullshift rather then being up for several hours because we do notphysically have the manpower.

Fast-forward your ownlife 50 or 60 years, would you want to be in along-term care facility, the kind that youwork in right now? In the state it is now?Absolutely not.

I would not want to bethe one in a bed in the state that long-termcare is in now.

-[ David ] If nursessay they are stretched, imagine personal supportworkers, the front line staff.

Those who wash, care, feed, lift, and keep safethe elderly.

Undercover, we are seeing itand hearing PSWs so burnt out, they are quitting.

-[ David ] It is not just thestress that is wearing on staff across the country.

They are often on thereceiving end of violence.

It's hard to make out but youcan see down the hallway that a resident is kicking oneof the staff members.

-[ Miranda ] Mmm-hmm.

-[ David ] How often do youhear about violent incidents against staff? -[ Miranda ] Every single day.

So much so, that it'sactually become the norm.

-[ David ] The violenceagainst staff is the norm.

Yeah.

Why would youwant to work there? My point exactly.

That's why we're short-staffed, that's why the PSW profession is not necessarily one that peopleare lining up to get into.

It's because, you know–the really sad thing, David, is when you sit with PSWsor in a room full of them, and I am many times with mymembers, and they will say, well, who got scratched today?And it's a joke.

Or who got bit today, you know? -[ David ] For its part, Markhaven did not want to do an interview but tellsus they provide a “safe and comfortableworking environment.

” They agree that more staff areneeded and say they provide the best care possiblewith the money they get from the government.

[ ♪♪ ] -[ David ] Back in Hare Bay, Sharon is fighting for change.

Angered by hermother's injuries, and no one beingaround to stop them.

This needs to change, it's totally unacceptable.

So, that's whenI created the group.

The Facebook group.

-[ David ] Her online communitynow has about 5, 000 members from across Canada callingfor legislative action, a campaign Sharonnames after her mother.

What is it that Lillian's Law, what you are proposing, is calling for? The initialthing is the ratio.

As there is a law for daycare, where you have a ratio of caregivers to children, we want the same for long-term care residents.

For people who can'tcare for themselves.

[ ♪♪ ] -[ David ] Every dayshe hears stories of residents left for hours without help.

And then the extremes.

A woman left in bedwith a broken hip, the doctor notcalled until morning.

What do they say? What sits with you? It's the same thing.

What has happened to my mother, there so many more extremes, so many more things that havehappened that should never have happened, and are worse.

-[ David ] Across the country, staff shortages in long-term care are making headlines.

In Québec, the ombudsman saysnursing homes are a disgrace.

The conditions the staffwork in are not acceptable.

-[ David ] Staff canbarely keep up.

[ Cheering ] -[ David ] And in Ontario.

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-[ Rallier ] Will you standwith us and keep fighting until seniors get thedignity they deserve?! [ Cheering ] -[ David ] A call for morestaff in long-term care.

[ ♪♪ ] The seniors helpedus build cities, build our province, and build our country.

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-[ David ] Supported by theprovincial Conservatives.

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[ Applause ] -[ David ] Then, Doug Ford won power.

Today we are announcing15, 000 new long-term care beds in the next five years.

-[ David ] Now he is promisingmore room for seniors in long-term care.

30, 000 new beds in ten years.

-[ David ] But with astaffing crisis right now, who is going to take careof the people in those beds? -[ David ] After two years ofinvestigating long-term care homes, we are seeing theimpacts of short staffing.

So, what is the solution, then? The solution is more staff.

We need more staff, we need more funding.

-You need more funding.

-Yeah.

-[ David ] We are showing ourhidden camera video to Candace Chartier, CEO of theOntario Long-Term Care Association which representsmost homes in the province.

We are asking the governmentfor $100 million a year for the next four years.

Do you think you will get it? I think they arelistening to us.

I think that if they– Because in this provincethere's a government intent on cutting costs.

It is, but it's a governmentthat's investing 15, 000 beds, new long-term care beds.

If we can't staff our currentbeds and you want to put 15, 000 more beds in the system, more staff has to happen.

Please hear me whenI say change is coming, help is on the way.

-[ David ] Ontario's new premierDoug Ford campaigned on helping seniors.

[ Applause ] -[ David ] We want to speakto him but his government has declined our interviewrequests for almost eight weeks.

We're talking to thepeople on the front lines, be it doctors, nurses, otherfrontline healthcare workers.

-[ David ] So we are catchingup with Doug Ford and his Health Ministerunannounced.

Minister Elliott, I'm David with CBC.

Can I just ask you a reallyquick question about long-term care? Sure.

The issue is specificallyaround frontline workers.

They are saying in long-termcare that there simply aren't enough of them for thebeds that exist right now.

Your government isannouncing even more beds.

How do you address the concernsthat frontline workers have around increasing residenton resident violence, about the fact that they, in some cases, have just six minutes to get even people withdementia, who are incapacitated, to get them up and dressedand to the washroom, to get them washed and getthem to breakfast– how do you address the concernsthese frontline workers have? We take their concerns veryseriously and what we are doing in the ministry right now is ahuman resource review of what healthcare professionals we needin various healthcare settings.

Are you committed to listeningto those frontline workers, people like personalsupport workers, who form the real frontline? Absolutely, that is whowe want to hear from.

We want to hear from frontlineworkers because we want to make sure that they feel safe inthe work that they are doing and that they are able todo it in the best way, the way that they weretrained to do it, and to make sure that all patientsreceive high-quality care.

[ ♪♪ ] -[ David ] It is toolate to help Marie's mom.

She died after months ofMarie sounding the alarm.

You'd been warning of problems.

I had been warningthem of problems.

Both the homeand the ministry.

And the ministry.

-And when did—And they failed me.

When did the ministry finallyrespond to your concerns? My report came in October.

By October, your mother is gone.

Yes.

-[ David ] And remember, it wasonly after reviewing this video that Marie uncoveredhow her mom died.

Her long-term care home, Markhaven, tells us they have now asked the OntarioMinistry Of Health to review Giovanna's death.

Meanwhile, in Newfoundland, Sharon is relentless in pushing for better care withmandatory staffing ratios.

Maybe if someone ispassionate enough about this, that we can inspire othersto do the same.

To come togetherand be a strong voice for those thatdo not have a voice.

Who put that certaintyand strength into you as a person? I think it was my mother.

To do what you can, and if thereis something that needs to be addressed and it iswrong, then it is wrong.

She's fighting for herselfthrough you.

Yes, I guess so.

[ ♪♪ ] -[ David ] Do you have lovedones in long- term care? Share your story.

E-mail us at [email protected]

ca.

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